Adding Erlotinib to Bevacizumab in EGFR-Positive Lung Cancer
Posted: Monday, July 1, 2019
Based on the interim analysis of the phase III NEJ026 clinical trial, conducted by Haruhiro Saito, MD, of the Kanagawa Cancer Center, Yokohama, Japan, adding bevacizumab to erlotinib in the treatment of patients with EGFR-positive, nonsquamous non–small cell lung cancer (NSCLC) improved progression-free survival compared with erlotinib alone. However, the combination therapy also led to more grade ≥ adverse events. The findings were published in The Lancet Oncology.
This multicenter study involved 224 patients who were randomly assigned 1:1 to receive either oral erlotinib at 150 mg/day plus bevacizumab at 15 mg/kg once every 21 days or erlotinib at 150 mg/day. Patients with EGFR-positive advanced NSCLC were selected from 69 centers across Japan, and the median follow-up was 12.4 months.
The median of progression-free survival was 16.9 months with erlotinib plus bevacizumab and 13.3 months with erlotinjb alone (hazard ratio = 0.605, P = .016). In a subgroup analysis by EGFR aberration type, the combination therapy demonstrated a significant benefit in the 113 patients with a Leu858Arg mutation and a nonsignificant benefit in the 111 patients with exon 19 deletions.
The median duration of erlotinib treatment was 405 days in the combination therapy group and 364 days in the erlotinib-alone group. Adverse events grade 3 or higher occurred in 88% of those treated with the combination therapy and 46% of those treated with erlotinib alone. No treatment-related deaths were reported.
“Future studies with longer follow-up and overall survival and quality-of-life data will be required to further assess the efficacy of this combination in this setting,” concluded the investigators.
Disclosure: The study author’s disclosure information may be found at thelancet.com.